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NPI Code Detail

MEDICARE: SUSAN KALAZ

MEDICARE: SUSAN KALAZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1689384521
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN KALAZ
Provider Business Mailing Address
First Line : 8149 WOODHAVEN BLVD APT 2A
Second Line :
City : GLENDALE
State : NY
Zip : 11385-8032
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2302 AVENUE U UNIT 290147
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-7504
Country : US
Telephone Number : 347-708-0777
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2022
Last Update Date : 01/24/2025

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Directions to “ SUSAN KALAZ ” Practice Location

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